| Granite House, Inc | |
|
288 E Green St Westminster MD 21157-5410 | |
| (410) 876-3007 | |
| (410) 751-7797 |
| Full Name | Granite House, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 288 E Green St, Westminster, Maryland |
| Authorized Official Name and Position | Spencer L Gear (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4108763007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granite House, Inc 288 E Green St Westminster MD 21157-5410 Ph: (410) 876-3007 | Granite House, Inc 288 E Green St Westminster MD 21157-5410 Ph: (410) 876-3007 |
| NPI Number | 1760408165 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 08/08/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760408165 | NPI | - | NPPES |
| T595 | Other | MD | BLUE CROSS BLUE SHIELD FE |
| 2095968 | Other | MD | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Maryland) | Primary |
| 261QR0400X | Clinic/center - Rehabilitation | (Maryland) | Secondary |
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